Communication Practices Recognized as Essential by Home-Visiting Nurses During the COVID-19 Pandemic in Japan: A Qualitative Content Analysis of Open-Ended Questionnaire Responses

Introduction: The COVID-19 pandemic placed severe strain on home-visit nursing, whose decentralized structure and limited resources created communication challenges distinct from those of hospital settings. Objectives: To qualitatively identify the communication practices and organizational conditions supporting them that home-visiting nurses perceived as essential during the COVID-19 pandemic across 4 domains: communication with clients and families, among staff, with other professionals and facilities, and managers’ communication of organizational response policies. Methods: In this qualitative descriptive study, an anonymous, self-administered questionnaire with open-ended items was mailed to all 577 home-visit nursing agencies in Hokkaido, Japan, between June and July 2022, targeting 1 manager and 1 staff nurse per agency. Responses were analyzed using inductive qualitative content analysis. Results: Valid responses were obtained from 390 participants. In communication with clients, a foundational attitude for building trust, along with psychological support and empathy, was considered essential for maintaining continuity of care. Among staff, information sharing to maintain team functioning and a supportive, consultative workplace environment were emphasized to reduce anxiety and isolation. In communication with other professionals, information sharing to sustain regional collaboration and mutual support were considered central. In managers’ policy communication, transparency in the decision-making process and considerate communication strategies were emphasized to alleviate anxiety among staff and clients. Conclusion: Communication in home-visit nursing during crises was perceived as essential for building trust, reducing isolation, and sustaining coordinated service delivery. Integrating these practices into organizational systems and education during non-crisis periods may strengthen resilience and preparedness for future health crises.